The time it takes to see a doctor or a nurse in casualty departments is also increasing, according to a major survey of 147 NHS trusts.

The findings are published today by the Care Quality Commission (CQC) which polled almost 46,000 patients. The survey reveals that A&E waits have got worse in the past eight years. A third of patients spent more than four hours waiting for treatment this year compared with a quarter in 2004.

Nearly a third waited more than half an hour before a doctor or nurse examined them.

This compares with 24 per cent in 2004. Almost 60 per cent of people were not told how long they would have to wait to be examined — up since 2004. However, most people said that they still had confidence and trust in health professionals.

Perceptions of the cleanliness of A&E units substantially improved from previous surveys. David Behan, CQC chief executive, said: “People should be seen, diagnosed, treated and admitted or discharged as quickly as possible. This is an issue trusts need to urgently tackle.”

The survey was carried out on people attending A&E during January, February and March this year.